STUDY DESIGN: A quasi-experimental single-blinded study. PURPOSE: To investigate the effects of ‘graded exercise integrated with education’ on physical fitness, exercise self-efficacy (ESE), and physical activity (PA) levels among subacute and chronic wheelchair-dependent paraplegia patients. OVERVIEW OF LITERATURE: Most of the chronic spinal cord injury (SCI) patients had low physical fitness due to a sedentary lifestyle and lack of ESE after discharge from a rehabilitation program. Education may encourage them to engage with exercise to regain and maintain their physical fitness. However, there is a lack of research to support the effects of exercise integrated with education after an SCI. METHODS: A total of 44 participants will be assigned to either the experimental group (graded exercise integrated with education) or active control (conventional physical therapy). The experimental group will receive graded strength and aerobic exercise training according to their progression criteria. They will attend an education program during and after the rehabilitation program. The control group will only receive conventional physical therapy during their in-rehabilitation program. This study will be conducted during a period of 16 weeks, consisting of 8 weeks of in-rehabilitation and 8 weeks post-rehabilitation. Statistical analysis will be performed using the IBM SPSS ver. 21.0 (IBM Corp., Armonk, NY, USA) at a significance level of p≤0.05. RESULTS: The primary outcome measures will be upper-limb isokinetic strength, isometric grip strength, and cardiorespiratory fitness. The secondary outcomes will be ESE and PA levels. CONCLUSIONS: An intervention that combines exercise training and education may be warranted to enhance the physical fitness, ESE, and PA levels in SCI patients. This trial was registered with ClinicalTrials.gov (NCT03420170).
Education ; Exercise ; Hand Strength ; Health Education ; Humans ; Motor Activity ; Non-Randomized Controlled Trials as Topic ; Outcome Assessment (Health Care) ; Paraplegia ; Physical Fitness ; Rehabilitation ; Sedentary Lifestyle ; Self Efficacy ; Spinal Cord Injuries ; Spinal Cord ; Spine

Objective: To determine the effects of the Paraplegia Fitness Integrated Training (PARAFiT) program, which is an integrated graded physical exercise and health education program for individuals with spinal cord injury (SCI). Methods: This nonrandomized single-blind study included 44 participants, who were assigned to either an intervention (PARAFiT) group or an active control (conventional physiotherapy) group. The intervention group underwent the PARAFiT program (8 weeks), which consisted of circuit-based interval training, progressive upper limb resistance training, and health education sessions. During the unsupervised period, the intervention group continuously underwent health education program once a month for 2 months (8 weeks). Repeated-measures analysis of variance was used for the analysis. Results: The intervention group presented with a higher level of physical activity than did the control group; however, the difference was not significant (p=0.36). Additionally, the intervention group presented with better exercise self-efficacy and cardiorespiratory fitness and stronger bilateral shoulder muscle and handgrip than did the control group (all p<0.05). Exercise adherence was higher in the intervention group than in the control group during both the supervised (80% vs. 75%) and unsupervised (40% vs. 20%) periods. Conclusion The PARAFiT program enhanced the level of physical activity, exercise self-efficacy, physical fitness, and exercise adherence among the patients with SCI. Future studies should incorporate guidelines for home-based exercises and regular monitoring to promote long-term adherence to exercise and physical activity among individuals with SCI.

INTRODUCTIONDiabetes mellitus (DM) is a chronic disease that is prevalent in many countries. The prevalence of DM is on the rise, and its complications pose a heavy burden on the healthcare systems and on the patients' quality of life worldwide.

MATERIALS AND METHODSThis is a multicentre, cross-sectional study involving 5 Health Clinics conducted by Family Medicine Specialists in Malaysia. Convenience sampling of 100 respondents with DM were selected. The International Classifi cation of Functioning, Disability and Health (ICF) based measures were collected using the Comprehensive Core Set for DM. SF-36 and self-administered forms and comorbidity questionnaire (SCQ) were also used.

RESULTSNinety-seven percent had Type 2 DM and 3% had Type 1 DM. The mean period of having DM was 6 years. Body functions related to physical health including exercise tolerance (b455), general physical endurance (b4550), aerobic capacity (b4551) and fatiguability (b4552) were the most affected. For body structures, the structure of pancreas (s550) was the most affected. In the ICF component of activities and participation, limitation in sports (d9201) was the highest most affected followed by driving (d475), intimate relationships (d770), handling stress and other psychological demands (d240) and moving around (d455). Only 7% (e355 and e450) in the environmental category were documented as being a relevant factor by more than 90% of the patients.

CONCLUSIONThe content validity of the comprehensive ICF Core set DM for Malaysian population were identified and the results show that physical and mental functioning were impaired in contrast to what the respondents perceived as leading healthy lifestyles.

Adult ; Aged ; Cross-Sectional Studies ; Diabetes Mellitus ; classification ; epidemiology ; Disability Evaluation ; Female ; Health Status ; Humans ; International Classification of Diseases ; Malaysia ; epidemiology ; Male ; Middle Aged ; Physical Endurance ; Quality of Life ; Surveys and Questionnaires ; Young Adult

Introduction: Physical inactivity is common among persons with disabilities (PWDs), thereby leading to harmful secondary complications. Therefore, this cross-sectional study aimed to identify the barriers to physical activity and exercise amongst PWDs in Malaysia. Methods: A total of 102 adults (age 15–65 years) with physical disabilities were recruited from a government-funded hospital. The participants completed the ‘Barriers to Physical Exercise and Disability’ questionnaire via interview by telephone calls or a one-to-one approach. Results: Most participants (90.2%) were interested in engaging in exercise programs. However, the mean concern index score was 2.83 ± 1.35. The majority of the respondents identified five major barriers. These barriers include health concerns (36.3%), transport barriers (36.3%), lack of energy and motivation (36.3%, 31.4%), and exercise program costs (23.54%). Conclusion: Many participants were interested in beginning an exercise program despite the barriers. This observation shows that if the barrier is eliminated, then, this community would be able to participate in an exercise program regularly. Results from the study can inspire health care providers to devise strategies for the promotion of physical activity participation and long-term adherence between PWDs.